First Mortgage Loan Application

Fields marked with a star (*) are required. Please call a Loan Officer at (513) 523-8888 if you have any questions.

Personal Information

*First Name

Middle Name

*Last Name

*SSN

*Birthdate (MM/DD/YYYY)

*Daytime Phone

*Email

*Marital Status

Married

Unmarried (Single/Divorced/Separated/Widowed)

*Mother's Maiden Name

Current Address (You must have a physical address. No P.O. Boxes.)

*Address

*City

*State

*ZIP

*Length of time at this address

County of Residence

*Do you own or rent your current home?

OwnRentOther

If Other, please explain

*Monthly Mortgage/Rent Payment

$

Employment & Income Information

*Current Employer

*Annual Earnings

$

*Length of Employment

*Employer Phone

Do you have any other sources of income? If so, please explain:

*Are you applying with a Co-Applicant?

YesNo

Co-Applicant Information (If you are not applying with a co-applicant, click here to skip to the next section of this form. Fields marked with a + are required if you are applying with a co-applicant.)

Yes, I am applying for a Home Equity Loan or Line of Credit. I have received and reviewed or will review the appropriate disclosures.

No, I am NOT applying for a Home Equity Loan Line of Credit at this time.

*Desired Loan Amount

$

*Approximate Value of the Property

$

*Desired Loan Term

*Loan Purpose

Home Purchase

Line of Credit

Debt Consolidation

Refinance

Cash Out

Other (please explain)

If Other, please explain:

*Will the proceeds from this loan be used for home improvement?

YesNo

*Will you be making a down payment?

YesNo

If Yes, how much?

$

*Do you already have a mortgage on the property currently?

YesNo

If Yes, what is the outstanding balance?

$

Who is it currently financed through?

*Do you currently have a second mortgage on the property?

YesNo

If Yes, what is the outstanding balance?

$

Who is it currently financed through?

Tell us a little more about your purchase. Is there anything else we should know about the purchase, in order to process your application?

Borrower Declarations

For the following questions, answer Yes if the situation is true for you or, if applicable, your co-borrower. If you answer Yes to any of these questions, you may be required to provide a written explanation.

*Are there any outstanding judgments against you?

Primary Borrower

Co-Borrower

YesNo

YesNo

*Have you declared bankruptcy within the past 7 years?

YesNo

YesNo

*Have you had property foreclosed upon, or have you given up a title or deed in lieu of foreclosure, within the last 7 years?

YesNo

YesNo

*Are you currently a party to a lawsuit?

YesNo

YesNo

*Have you directly or indirectly been obligated on any loan which resulted in foreclosure, or in transfer of title in lieu of foreclosure?

YesNo

YesNo

*Are you presently delinquent or in default on any federal debt or any other loan, mortgage, financial obligation, bond, or loan guarantee?

*Have you had an ownership interest in a property within the last 3 years?

YesNo

YesNo

What type of property did you own?

Primary Residence

Second Home

Investment Property

Primary ResidenceSecond HomeInvestment Property

How did you hold the title to the property?

Solely By Yourself

Jointly with Your Spouse

Jointly with Another Person

Solely By YourselfJointly with Your SpouseJointly with Another Person

Fair Housing Information

Information For Government Monitoring Purposes
The following information is requested by the Federal government for certain types of loans related to a dwelling, in order to monitor the Lender's compliance with equal credit opportunity, fair housing, and home mortgage disclosure laws. You are not required to furnish this information, but are encouraged to do so. The law provides that a lender may discriminate neither on the basis of this information, nor on whether you choose to furnish it. If you furnish the information, please provide both ethnicity and race. For race, you may check more than one designation. If you do not furnish ethnicity, race, or sex, under Federal regulations, this Lender is required to note the information on the basis of visual observation or surname. If you do not wish to furnish the information, please check the box below. (Lender must review the below material to assure that the disclosures satisfy all requirements to which the Lender is subject under applicable state law for the particular type of loan applied for.)

Primary Borrower

Check this box if you do not wish to provide this information.

Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Race

American Indian or Alaska Native

Native Hawaiian or Other Pacific Islander

Black or African American

Asian

White

Sex

MaleFemale

Co-Borrower (if applicable)

Check this box if you do not wish to provide this information.

Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Race

American Indian or Alaska Native

Native Hawaiian or Other Pacific Islander

Black or African American

Asian

White

Sex

MaleFemale

Insurance Information

Are you interested in purchasing additional insurance on this loan? If so, please check the boxes for the insurance products you would like:

Single Credit Life Insurance

Single Disability Insurance

Joint Credit Life Insurance

Joint Disability Insurance

Disclosures

Notice to Ohio Residents: The Ohio laws against discrimination require that all creditors make credit equality to all creditworthy customers, and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with this law.

I (We) certify that the above information is true and complete. I (We) also authorize the credit union to verify or obtain further information that the credit union may deem necessary concerning my (our) credit standing. If an account is opened, I (we) authorize you to report our credit experience with me (us). The undersigned jointly and severally agree to be responsible for all charges. I (We) hereby authorize Miami University Community Federal Credit Union to act on my (our) behalf to transfer the balance(s) listed above to my new Miami University Community Federal Credit Union credit card. Miami University Community Federal Credit Union reserves the right to transfer only the current credit card balance(s).